Our laser surgery results are among the very best I have seen, 98% percent of our patients see 20/20 or no worse than 20/25 after their first treatment. I wish I could claim it is because we are such gifted surgeons, but in reality it is because we are so compulsive about how we gather patient data pre-operatively and even more important is how we collect data post-operatively. Having watched international surgeons go through the learning process of how to program the laser was very enlightening. The early days of laser surgery in the late 1980's and early 1990's consisted of the Canadians and the Europeans learning one eye at a time how to program the laser to do each correction. Sometimes the success rate was less than 25%. I didn't want to be part of that learning curve as a patient or doctor. Those doctors who became very good at getting great vision for their patients were those who compulsively tracked their outcomes, and adjusted the way they programmed the laser based on that experience. Patients mistakenly think that all laser vision correction surgeons track their data. Unfortunately that is not true. Why not? Because it is expensive to pay for staff and doctor time to see your own patients in follow-up, and then enter all that data in a proprietary program so you can track outcomes. We go over the odds of 20/20 results with each patient before surgery. Then it is up to the individual patient to decide if those results are adequate for them to have surgery. No honest doctor ever promises a patient an outcome. No matter how many patients we have performed surgery on, we have never done anyone with your specific genetic or healing characteristics. You will heal as you are preprogrammed to heal. However, we do try to control every variable possible.   [less]

Yes. Please see question “How good are your LASIK results?”

The first measure we take is to use the finest equipment possible to insure each patient's candidacy for laser vision correction as detailed in the question “What technology do you use for surgery?”. For surgery, we use only what we feel is the finest equipment available, the German engineered Hansatome Microkeratome and the Visx Star S4 IR Laser. Safety for our patients is our number one priority. I often say, "If the procedure is not safe for you, you don't want to have it." That is why we do our pre-operative measurements so carefully. We check and double-check everything. In surgery we have a series of procedural steps which we compulsively follow to assure that the calculations we use are the very best for your eyes. We test run both the laser and the microkeratome and calibrate them individually before each eye we treat. We have a backup power supply in case of electrical fluctuation. Everything we do is done to insure safe, predictable outcomes for our patients.   [less]

We as your surgeons insist on doing the follow-up exams on our patients at the one day and one week visits. The exception is for patients from outside the area. In some cases, we work with outlying doctors who we know are well trained to do the early post-op visits. The remainder of the follow-up visits are mostly done to monitor your healing progress and for data collection. Some of these visits are with other doctors on our staff here at Griffin and Reed Eye Care.  [less]

Prior to surgery during the initial evaluation, each patient is scanned on our Pentacam. In order to proceed to surgery, the Pentacam must confirm our measurements and findings during the evaluation for absolute safety. Safety for our patients is our first priority when it comes to laser vision correction. Not only must the health of the eyes and the patient be considered, but some critical standards of eligibility must be met. Testing of the eyes with scans and devices not normally used in routine eye exams help to include or exclude persons seeking laser eye surgery to make it the safest possible choice for each patient. Since laser vision correction is done on the cornea, the health and integrity of that part of the eye is critical for safe and predictable outcomes. Previously, doctors only had scans such as corneal topography as a method of measuring elevations, irregularities and curvature of the cornea. These topography scans are capable of showing possible problem areas, but are limited to a view of the front surface of the cornea only. Subtle abnormalities of the back, or posterior surface of the cornea are impossible to measure with conventional instruments. These subtle abnormalities of the back side of the cornea are often responsible for unpredictable and sometimes very poor visual outcomes after laser eye surgery. Devices such as the Orbscan I and II have been around for several years and give some indication of the posterior corneal surface, but often underestimate or overestimate true corneal contours and curvatures that are critical to surgeons advising patients seeking laser eye surgery. The lack of measurements that are repeatable and absolute has been a source of frustration to many laser eye surgeons. At times patients were told they were not candidates based on incorrect information, and even more critical, sometimes patients underwent LASIK surgery that probably should not have had surgery due to unreliable measurements. Then the Oculus company out of Germany developed the Pentacam. What is a Pentacam? In our opinion the Pentacam is a critical diagnostic tool for laser eye surgeons. It utilizes a sophisticated Scheipmflug camera system that scans the anterior eye (cornea, anterior chamber, iris, and lens) and takes up to 25,000 measured data points in a scan time of 2 seconds per eye. From all this data a 3D model of the eye is constructed that can be viewed and analyzed by the doctor. The data collected allows us to view the eye from 25 different angles with a three dimensional analysis of all the structures mentioned above. Most importantly for potential laser vision correction patients it allows us to have a precise elevation map of the back surface of the cornea unparalleled by any previous technology. This information helps us to make sure the recommendations we make for laser vision correction will be as safe as possible. The 3D capability of the image allows us to see if lens implants for very near or farsighted patients might be a better option than laser surgery. We can also grade the level of cataract development in the lens of the eye and follow its progress with serial scans. For patients who have undergone previous laser vision correction who are now or at some time in the future will be in need of cataract surgery, we are able to more accurately calculate the lens implant replacement power with the true corneal curvature measurements (keratometry readings) that are provided by the Pentacam. In addition some corneal conditions such as keratoconus, pellucid degeneration, or corneal ectasia can be monitored for stability or progression with the Pentacam. This allows us to help these patients with the best contact lens or other vision correction option for their particular need. Our enthusiasm for the potential uses of the Pentacam sometimes leads us to get carried away. Put quite simply, every patient we see who is contemplating laser eye surgery or lens replacement surgery is scanned with the Pentacam. That way we are able to provide the safest and most accurate treatment choices for those who put their trust in us. In our opinion there is no instrument that is more detailed, accurate, and helpful as a diagnostic device in determining a patient's candidacy for laser vision correction as is the Pentacam. Our office is the first in the greater Sacramento area to offer our patients the benefits of the Pentacam. The technology we use for the actual laser procedure consists of the Visx Star S4 IR Laser and Hansatome Microkeratome as mentioned in previous questions. Our specific laser has the Visx exclusive Iris Registration and tracking modules for the most accurate eye tracking during laser surgery possible. We always have the latest version of the Visx Laser. It is constantly serviced and maintained to keep it in pristine working order. We use the German engineered Hansatome Microkeratome for creation of the flap during LASIK surgery. Our doctors feel that though more expensive than many other microkeratomes in use the Hansatome offers our patients the safest possible way to make a flap for LASIK surgery. We also employ the CustomVue Wavefront measurement system for determining the unique imperfections (high order aberrations) peculiar to each individual eye. We also use the Marco Wavefront Aberrometer for comparison with our Visx system. We also use many other diagnostic tools and measuring instruments to evaluate our patients that are too numerous to mention here.   [less]

To answer the first part of that question adequately, we start with a free, initial consultation here in our office with the surgeon of your choice. At this appointment, we will perform a series of diagnostic tests to ensure your candidacy for laser vision correction. We will also see you for additional preoperative appointments before surgery. Over the course of these visits, your eyes will be scanned by several diagnostic instruments and our doctors will perform a dilated retinal examination to assess your ocular health. Also, we will perform our exclusive Pentacam scan (detailed in question #15) and your surgeon will review the results with you. Consideration will be given to how you use your eyes in a typical workday, what your visual needs are in your leisure time and most importantly, what you hope to gain from laser vision correction. Until we get to know you and your unique life needs, any answer is inadequate. In regard to other evaluations, they all differ. They are usually done by a technician or staff member and sometimes by an Optometrist. At most high volume centers, you don't meet your surgeon until minutes before your actual surgery (detailed in question #2). Many patients tell me they have been told they are good candidates for surgery at some other center. Often that candidacy is based on their ability to pay for the surgery, not whether it is the best option for them in order to better their life. Our comprehensive consultation and preoperative appointments will include some familiar tests: refraction, pupil exam, eye motility exam, confrontational visual field, slit lamp exam, intraocular pressure, and dilation. However, there are additional examinations that are routinely done in our Sacramento practice for potential laser vision correction patients. They include the Pentacam scan, corneal thickness measurements, corneal curvature measurements using sophisticated corneal and eye mapping devices, WaveScan analysis of individually unique abnormalities in vision using both the Visx CustomVue system as well as the Marco Wavefront analyzer. All this data is gathered and analyzied during your preoperative visits with us. The data is then carefully correlated with a comprehensive history of how you use your eyes during a typical day. We also determine what your visual needs are during relaxation and recreational times as well as what your visual expectations are from laser vision correction. All that information is then evaluated in a personal consultation with your surgeon, who together with your input will use their expertise to advise you if laser vision correction is right for your eyes and your needs. The collection of data usually requires a surgery patient to return to our office for more than one visit to compare data from the various tests until the most accurate repeatable data has been gathered. Then and only then can an accurate calculation be performed and an individual program be designed to correct your vision. Anything less is nothing more than generic laser vision correction surgery also known as "plug and play" laser vision correction. The expertise to program the excimer laser most accurately for any given patient not only comes from all the testing, interviewing and counseling together, but finally is based on years of data collection that Griffin and Reed Eye Care has compiled for the thousands of patients we have treated. We track all our patients' postoperative results and have always insisted on doing so. The need for carefully tracking patient results was evident after watching the evolution of laser vision correction outcomes. In the late 1980's and early 1990's, the surgery outcomes in Europe, Great Britain, and Canada were generally quite poor. As visual outcomes became better, it was very clear that surgeons who achieved outstanding visual results for their patients were those who gathered data as methodically as possible and then did careful follow-up and correlation of their patients' visual outcomes one by one. If you wanted to help your patients achieve the best possible visual outcomes it was apparent that you had to see them in follow-up and, most importantly, continue to hone the programming of the laser based on that ongoing experience. Having patients come in for follow-up exams and tracking data is expensive and time consuming, but that is the only way to know for sure that those who trust us are seeing the way they should. That is why high numbers of eyes treated without continuity of follow-up and patient care speaks more to running a laser vision correction surgery mill than a medical practice. We have seen a number of laser vision correction surgeons, surgery mills, and corporate chains come and go. We will see more come and go. Often these chains will even hire the surgeon from a corporate chain that previously failed in the area. There will be more bait and switch pricing schemes, more tier pricing where every little thing costs more. There will be more "closers" trying to find a trusting patient's "price point" for laser vision correction surgery. There will be more phony lifetime guarantees and cleverly disguised disclaimers, also known as the "20/40 waiver" (see "What is your retreatment policy and will I have to sign a 20/40 or 20/30 waiver?") . There will be more people trying to commoditize laser vision correction surgery. Remember, you're not buying a TV. If you don't like the picture, you can't return the eyes.   [less]

Our consent form lists every complication we have ever read about in the world's literature for laser vision correction surgery. As a result reading it is a somewhat intimidating experience. The reason for such horrific documents is so we can obtain malpractice insurance coverage in California. Those who know the practice of medicine from the inside know that the risks and outcomes of surgery vary significantly depending on who does the surgery and how they do it. The risks that I worry about most with LASIK patients involve the risk of them "tweaking" their flap in the first 18 hours after surgery. A slight wrinkle in the flap can cause a decrease in vision. This is repairable in most cases, but delays good visual recovery. We also watch closely for infection or inflammation after surgery. Our experience is that these issues show up very rarely, (one in 2-3000) but are much easier to treat when caught early. That is why we insist on seeing you ourselves the day after surgery. Patients are placed on eye drops to control those problems. Usually infection or inflammation is seen very early, and the one day and one week follow-up visits further insure that you will be monitored for and promptly treated for those problems. Additional complications can arise for patients if they elect to have surgery at another center if they do not use the Visx Star S4 IR Laser and German engineered Hansatome Microkeratome as mentioned earlier in questions.   [less]

Everything we do is designed to minimize risk and maximize benefit or outcome. We insist on treating the laser vision correction surgery area as a sterile operating facility. The staff wears masks and gloves as well as surgical scrubs. Since infection and inflammation are much less likely to occur with sterile conditions, we observe sterile protocol in surgery. In some facilities, the surgeon and staff dress in street clothes or don't use gloves and masks. Tours are even given of the surgery suite. We think that only increases the risk of contamination and exposure to the patients. Our entire focus is based on making laser vision correction surgery as risk free as possible.   [less]

A professor of medicine once told me, "If you don't want to deal with litigation, then don't practice medicine." I don't know any doctor who has never been sued. We are not currently involved with any litigation. However, we have been sued in the past and will probably be sued in the future. Unfortunately the right to bring a civil suit against a doctor does not require any reasonable justification and with the vast number of people we see with all types of personalities, it is to be expected. No judgment has ever been found against us.  [less]

Custom (WavePrint) laser vision correction and its application using sophisticated iris tracking is the latest advance in laser vision correction. Besides being nearsighted, farsighted and astigmatic in various combinations we all have some unique imperfections in the way our eyes bend light. No two eyes or patients have the same unique imperfections. That is why these unique imperfections, or Wavefront abnormalities as they are known, have come to define what we call the "fingerprint" of your eye. CustomVue or Wavefront treatment allows us to not only treat the things glasses and contact lenses correct, but also these unique abnormalities. Every patient we see has a WaveScan analysis with both the Visx and Marco Wavefront machines. We then carefully evaluate the type and amount of these imperfections with each patient and make recommendations as to whether custom laser vision correction is appropriate for each individual. Many surgeons tell all their patients they need the more expensive Custom or Wavefront treatment when truthfully they don't. The reason they tell patients they need to have custom laser vision correction is to reduce their retreatment rate. Patients are essentially paying more to reduce the surgeon's retreatment rates if they use, "plug and play". We have found that approximately 25% of nearsighted and astigmatic patients need custom laser vision correction. We explain every option in full detail to each of our patients. The benefits of custom laser correction are slightly higher in farsighted/astigmatic patients. We don't feel that you should have to pay more for custom laser vision correction unless it is medically beneficial.   [less]